Treatment Modalities and Perceived Effectiveness of Treatment Among Adults With Depression

Abstract

Patient-reported outcomes of mental health treatment, such as perceived effectiveness, are important. They indicate whether treatment is perceived to reduce symptoms and minimize psychiatric disability. Outpatient treatment for depression typically includes medication or counseling, either alone or in combination. This study examines the relationship between treatment modality and perceived effectiveness of treatment. Using a sample of adults who received outpatient treatment for depression from the 2015-2016 National Survey on Drug Use and Health (N = 4169), logistic regressions estimated the odds of rating treatment as effective among persons who received medication only, counseling only, and a combination of medication and counseling. There were no differences in perceived effectiveness between counseling only and medication only. However, receiving both was associated with greater odds of rating treatment as effective. Poor self-rated health and severe mental illness were associated with lower perceived effectiveness of medication. Those with substance use problems had lower odds of rating counseling and both counseling and medication as effective. A combined treatment for depression may be perceived as better than single-modality treatment. Therefore, there might be benefits to increasing access to both forms of treatment for persons less likely to rate either single modality as effective.

Perceived helpfulness of depression treatments among young adults with autism

“…Of those who received individual therapy, a high proportion (69%) also reported using medication. However, unlike general population findings (Alang & McAlpine, 2020;Harris et al, 2020), receiving medication and individual therapy concurrently was not significantly associated with the level of perceived helpfulness of either type of treatment. Previous studies collected one overall rating of perceived helpfulness for participants receiving multiple treatments, whereas we asked participants to rate each type of treatment separately.…”

“…Our findings indicate that while the perceived helpfulness of depression treatments varied widely, most adults in this community sample perceived medication and individual psychotherapy as moderately helpful or better, indicating that the "subjective" effectiveness of community treatments for depression was mostly satisfactory. Investigation of potential correlates of perceived helpfulness found that adults with ASD with more selfreported depressive symptoms were less likely to perceive treatments as helpful, which is consistent with findings from the general population (Alang & McAlpine, 2020;Hemmis et al, 2015). It is possible that individuals starting with more depressive symptoms were less likely to perceive treatment as helpful (regardless of the objective effectiveness of treatments), or that treatments were indeed less helpful for more depressed individuals and/or those presented with more complex cases of depression.…”

“…Perceived helpfulness captures aspects of treatment effects and acceptability that are unique from more "objective" outcomes. Studies in the general population have shown that when patients perceive depression treatment to be helpful, they are more likely to follow through with the treatment (adherence) (Lippens & Mackenzie, 2011), to be satisfied with the treatment (Alang & McAlpine, 2020), to benefit from the treatment or recover (Ojala & Wheeler, 2012), and to seek and utilize future treatments when in need (Colman et al, 2014;Edlund et al, 2002).…”

“…Further, understanding individual correlates of perceived helpfulness could provide additional information about what is likely to be perceived as most helpful by which patients. For example, studies on perceived helpfulness of depression treatment in the general population have found patients' helpfulness ratings to be associated with various demographic characteristics (e.g., age, sex, education levels), as well as depression symptom severity (e.g., self-rated levels of depression), and depression treatment status (e.g., whether receiving multiple treatments at the same time) (Alang & McAlpine, 2020;Harris et al, 2020).…”

Perceptions of cognitive behavioral therapy, aerobic exercise, and their combination for depression.

“…Because several factors such as body mass index (BMI), motivation, fatigue, and mood all negatively influence perceptions of exercise, we hypothesized that participants would view this treatment option as generally more difficult than CBT, and that a combined treatment option would be perceived as even more difficult than CBT alone (Busch et al, 2016; Seime & Vickers, 2006; Vartanian & Novak, 2011). We also hypothesized that participants would view the combined treatment as more effective than either treatment alone, as previous work has suggested when clients combine two different therapies (Alang & McAlpine, 2020).…”